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Molina Medicare Complete Care Plus (HMO D-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Molina Medicare Complete Care Plus (HMO D-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Molina Medicare Complete Care Plus (HMO D-SNP) in 2026, please refer to our full plan details page.
Molina Medicare Complete Care Plus (HMO D-SNP) is a HMO D-SNP plan offered by Molina Healthcare, Inc. available for enrollment in 2026 to people living in Collar counties in IL. The overall rating for this plan is not yet available for 2026.
It's important to know that Molina Medicare Complete Care Plus (HMO D-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Molina Medicare Complete Care Plus (HMO D-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Molina Medicare Complete Care Plus (HMO D-SNP).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Molina Medicare Complete Care Plus (HMO D-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $615.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $9250.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
Sign up for Molina Medicare Complete Care Plus (HMO D-SNP)
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Drug Coverage
The Molina Medicare Complete Care Plus (HMO D-SNP) plan features an annual drug deductible of $615. Under this plan, you will pay no copay for Tier 1 preferred generics, Tier 2 generics, and Tier 6 select care drugs when filled at standard pharmacies or through standard mail order. For other medication tiers, costs are based on coinsurance rather than flat copays. You will pay a 20% coinsurance for Tier 3 preferred brand drugs and a 30% coinsurance for Tier 4 non-preferred drugs. Additionally, Tier 5 specialty drugs require a 25% coinsurance for a one-month supply at standard pharmacies and mail-order services.
Additional Benefits
The Molina Medicare Complete Care Plus (HMO D-SNP) offers robust medical coverage featuring no copays for major services like inpatient hospital stays, primary care, and skilled nursing facility care. While copays are largely eliminated under this plan, members are typically responsible for a 20% to 30% coinsurance on outpatient services, specialist visits, emergency care, and diagnostic tests. Additionally, essential services such as dialysis, medical equipment, and ambulance transportation are covered with no copay and a 20% coinsurance. For supplemental care, the plan provides preventive dental, routine vision, and hearing benefits with no copays and no coinsurance, though certain comprehensive services and exams may require a 20% coinsurance. Members also enjoy valuable extra benefits with no copay and no coinsurance, including unlimited transportation to plan-approved locations, home health services, and over-the-counter items.
Inpatient Hospital See details
Inpatient hospital services are partially covered by Molina Medicare Complete Care Plus (HMO D-SNP) with no copay and no coinsurance for acute and psychiatric stays, though prior authorization is required. Additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers outpatient services—including outpatient hospital, ambulatory surgical center, substance abuse, and blood services—with no copay and a 20% coinsurance. Prior authorization is required for most of these outpatient services, and there is no deductible for outpatient blood services.
Partial Hospitalization See details
Partial hospitalization services are covered under the Molina Medicare Complete Care Plus (HMO D-SNP) plan with no copay and a 30% coinsurance. Prior authorization is required for these services.
Ambulance and Transportation Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers ground and air ambulance services with a 20% coinsurance and no copay. Transportation services are partially covered, offering unlimited trips to plan-approved locations with no copay or coinsurance, though transportation to any health-related location is not covered.
Emergency Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers emergency and urgently needed services with a 30% coinsurance and no copay, with the emergency coinsurance waived if you are admitted to the hospital within 24 hours. Worldwide emergency, urgent, and transportation services are also covered with no copay and no coinsurance up to a maximum benefit limit of $10,000.
Primary Care See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers primary care, specialist, therapy, psychiatric, telehealth, and opioid treatment services with no copays and coinsurance ranging from 20% to 30%. Chiropractic care is partially covered, offering up to 20 routine visits per year with no copay and 30% coinsurance, while other chiropractic services are not covered.
Preventive Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) offers partially covered preventive services with no copay and no coinsurance for annual physicals, fitness benefits, and nutritional counseling. Other covered benefits, including kidney disease education and glaucoma screenings, have no copay but require a 20% coinsurance, while services such as in-home safety assessments, medical nutrition therapy, and weight management programs are not covered.
Hearing Services See details
Hearing services are covered by Molina Medicare Complete Care Plus (HMO D-SNP), offering routine hearing exams with no copay and a 20% coinsurance, alongside OTC hearing aids with no copay and no coinsurance. Prescription hearing aids are partially covered with no copay and no coinsurance, though inner ear, outer ear, and over the ear types are not covered.
Vision Services See details
Vision services are partially covered by Molina Medicare Complete Care Plus (HMO D-SNP) with no copays, no deductibles, and a 20% coinsurance for routine eye exams and contact lenses. This benefit includes one routine eye exam per year and a $250 annual allowance for eyewear like contact lenses, eyeglasses, and upgrades, though other eye exam services are not covered.
Dental Services See details
Dental services are partially covered by Molina Medicare Complete Care Plus (HMO D-SNP), offering Medicare-covered dental with no copay and a 20% coinsurance, and other covered preventive and comprehensive services with no copay and no coinsurance. Non-covered services include other diagnostic dental, other preventive dental, maxillofacial prosthetics, implant services, fixed prosthodontics, and orthodontics.
Home Infusion bundled Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers home infusion bundled services with no copay, subject to prior authorization. Under this plan, Medicare Part B chemotherapy and other drugs have no copay and coinsurance ranging from no coinsurance to 20%, while Part B insulin drugs require a $35 copay and coinsurance ranging from no coinsurance to 20%.
Dialysis Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers dialysis services with no copay and a 20% coinsurance.
Medical Equipment See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers medical equipment, including durable medical equipment, prosthetics, and diabetic supplies, with no copay and a 20% coinsurance. Prior authorization is required for these benefits, and some equipment may be limited to preferred vendors or manufacturers.
Diagnostic and Radiological Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers diagnostic and radiological services, including lab services, diagnostic procedures, therapeutic radiological services, and outpatient X-rays, subject to prior authorization. There is no copay for these services, but members are responsible for a 20% coinsurance.
Home Health Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers Home Health Services with no copay and no coinsurance. Prior authorization is required to receive these covered services.
Cardiac Rehabilitation Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) provides Cardiac Rehabilitation Services with no copay, meaning some services are covered; however, standard cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered in practice and require a 30% coinsurance.
Skilled Nursing Facility (SNF) See details
Molina Medicare Complete Care Plus (HMO D-SNP) partially covers skilled nursing facility (SNF) services with no copay and no coinsurance, although prior authorization is required. This benefit does not require a prior three-day inpatient hospital stay for admission, but additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Molina Medicare Complete Care Plus (HMO D-SNP) covers other services with no copays and no coinsurance, including over-the-counter items and a limited-duration meal benefit, though acupuncture is not covered. The meal benefit requires prior authorization and is available following hospitalizations or for chronic illnesses.
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